| NPI | 1902913460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WV 02095) |
| Additional Taxonomies | 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL OS11752) |
| 207Q00000X Family Medicine (Licence: FL OS11752) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2013-10-25 |